老年直肠癌永久性结肠造口患者生存质量、心理精神调查分析

摘要

Objective To analyze the quality of life and psychological status of elderly patients with rectal cancer after permanent colostomy.Methods Quality of life questionnaire-core 30 (QLQ-C30) and Symptom checklist 90 (SCL-90) were tested by selfreport questionnaire in 64 elderly patients with rectal cancer before and after permanent colostomy in the first,third and sixth month after the operation.The correlation between QLQ-C30 scores and SCL-90 scores were analyzed.Results There were 60 patients completing the survey.The scores of overall health,functional scales (physiological function,role function,affective function,cognitive function,and social function) of QOL-C30 scale after one month of operation were significantly lower than before operation.All the scores were improved greatly in the third and sixth month after operation (P ＜ 0.05).The scores of symptom areas and symptom sub-entries in the first,third and sixth month after operation were significantly higher than before operation (P ＜ 0.05).The total score,the scores of anxiety,depression and somatization of SCL-90 in the first month after operation were significantly higher than before operation (P ＜ 0.05).The somatization score in the third and sixth month after operation were significantly increased,while the total score,the scores of anxiety and depression were significantly decreased (P ＜ 0.05).The Pearson correlation analysis showed that the total score,the scores of anxiety,depression and somatization in the SCL-90 were negatively correlated with the overall health,functional scales in the QLQ-C30.The psychological status negatively affected emotional function and general health (P ＜ 0.05).Conclusion Elderly patients with rectal cancer after permanent colostomy have obviously psychological abnormality,which affects the quality of life significantly.The targeted mental nursing can improve the quality of life.%目的 探讨老年直肠癌永久性结肠造口患者术后生存质量及精神心理状况.方法 采用生存质量核心问卷(QLQ-C30)及症状自评量表(SCL-90),对64例老年直肠癌永久性结肠造口患者分别于术前、术后1、3、6个月进行问卷调查,并对QLQ-C30评分与SCL-90评分进行相关性分析.结果 完整参加本次调查的患者共60例.术后1个月QOL-C30量表中总体健康、功能领域(生理功能、角色功能、情感功能、认知功能、社会功能)评分显著低于术前,术后3、6个月有明显改善(P＜0.05);术后1、3、6个月症状领域及症状子条目评分显著高于术前(P＜0.05);术后1个月SCL-90量表总评分、焦虑、抑郁、躯体化评分显著高于术前,术后3、6个月躯体化评分显著升高,焦虑、抑郁及总评分显著降低(P＜0.05);SCL-90量表总评分、焦虑、抑郁、躯体化评分与QLQ-C30量表中总体健康、功能量表评分呈显著负相关性,且能够显著影响情绪功能及总体健康(P＜0.05).结论 老年直肠癌永久性结肠造口患者术后具有明显的心理精神异常,且直接影响生存质量,早期针对心理护理有利于提高患者的生存质量.